AHPRA goes further on telehealth prescribing ‘good practice’

Update: 6.30pm, Thursday 9 October: AHPRA has now amended its website and clarified that there has been no change to the telehealth guidelines from the Medical Board of Australia.

New telehealth guidance issued by the Australian Health Practitioner Regulation Agency (AHPRA) goes substantially beyond existing guidelines, advising that prescribing should only take place after a face-to-face consultation.
 
The update issued on Tuesday, which AHPRA described as ‘consistent’ with current Medical Board of Australia (MBA) guidelines, in fact goes notably further than the previously published document which came into effect in September 2023.

In its announcement, AHPRA states that telehealth good practice constitutes ‘only prescribing if you’ve consulted with the patient face-to-face before’.
 
The wording is substantially stronger than the current advice, which includes the following:
 
‘Prescribing or providing healthcare for a patient without a real-time direct consultation, whether in-person, via video or telephone, is not good practice and is not supported by the Board.’
 
The newly issued advice has already caused speculation about the implications for online prescribing business models that have mushroomed in recent years.
 
When queried by newsGP about the difference, the regulator said definitions of good practice help practitioners meet patients’ needs and their own professional obligations. 
 
‘It is informed by evidence and goes to a practitioner’s clinical judgement,’ an AHPRA spokesperson told newsGP.
 
‘AHPRA continues to respond to concerns around prescribing via telehealth. When concerns arise, practitioners are asked to provide further information about how they exercise their clinical judgement to meet the patient’s needs and their own professional obligations.    
 
‘While face-to-face consultations before prescribing remain best practice, there may be circumstances in which a practitioner can demonstrate that an alternative approach to that broadly defined as “good practice” is, in their professional judgement, appropriate and safe.’ 
 
The update issued by the regulator ‘confirms there are the same expectations for all practitioners when providing safe and effective telehealth services’.
 
It was released against the backdrop of widespread concern about the impact of so-called ‘vertically integrated clinics,’ particularly for medicinal cannabis, and includes several case studies highlighting poor practice in that field.
 
Prescribing and dispensing rates of high-strength tetrahydrocannabinol have skyrocketed in recent years. Last month, AHPRA issued new advice for pharmacists supplying medicinal cannabis products, having issued new guidelines for prescribers in July.
 
Both prescribers and dispensers are warned to be ‘as careful and diligent’ with the prescription and supply of medicinal cannabis as they would be with other drugs of dependence.
 
AHPRA also flagged concerns over emergency department presentations showing medicinal cannabis-induced psychosis as well as ‘evidence of over-servicing and ethical grey areas around single-purpose dispensaries’.
 
In the advice issued this week, AHPRA repeatedly stresses that the onus is on individual health practitioners rather than their employers to justify their clinical decisions.
 
‘Practitioners working in telehealth-only clinics, particularly those focused on single treatments or medicines, are encouraged to review the clinical governance framework to ensure the care they provide isn’t compromised by commercial gain or convenience,’ it said. 
 
Following the release of the update, and AHPRA’s response to the difference from current guidelines, newsGP asked medical indemnity organisations Avant and MDA National for their view on any implications for GPs working under telehealth business models.
 
Avant was unable to comment in time for publication, while MDA National declined to comment.  
 
The MBA guidelines remain current, with a review scheduled ‘from time to time as required’.
 
‘This will generally be at least every five years,’ the document states.
 
According to the Australian Bureau of Statistics, 23.6% of the population had a telehealth consultation in 2023–24, including 19.7% with a GP.
 
AHPRA says the growth in telehealth services has been accompanied by an increase in related notifications, which climbed to 586 in 2024–25. 
 
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AHPRA medicinal cannabis prescribing telehealth